A construção desta tese está alicerçada na inter-relação entre profissionais e usuários do Sistema Único de Saúde (SUS), no que diz respeito às questões relativas a saúde mental relacionada ao trabalho. Existem atualmente propostas relativas a políticas e ações voltadas à saúde dos trabalhadores, porém o campo de práticas, neste contexto, não tem produzido respostas significativas para atender as demandas de sofrimento psíquico do trabalho. Assim, esta pesquisa se propôs a compreender de que modo os profissionais da saúde percebem a saúde mental relacionada ao trabalho vivenciada pelos usuários do SUS. O embasamento teórico e metodológico está fundamentado na Psicodinâmica do Trabalho e nas teorias voltadas para a Saúde Mental e Trabalho. O método de pesquisa foi baseado na Psicodinâmica do Trabalho, em que foi realizada uma adaptação da proposta strictu sensu, sendo composta pela pré-pesquisa, pesquisa propriamente dita e pela perlaboração como validação. Participaram da pesquisa mulheres e homens que atuam como profissionais da saúde no SUS. O material de análise e interpretação resultou de 15 entrevistas individuais e 4 coletivas, totalizando 69 participantes. Além disso, registros realizados no diário de campo também integraram o material analisado, fundamentando assim a observação clínica. Os resultados se propuseram a atender aos objetivos da investigação e originaram cinco eixos-temáticos, sendo estes: Trabalho e Subjetividade: Entre Saberes e Fazeres; Saúde Mental e Trabalho no SUS: Articulações em Rede; Organização do Trabalho nos Serviços do SUS; Produção de Saúde e Adoecimento no Trabalho; Pesquisa-Intervenção como Possibilidade de Reflexão-Transformação. Ao falar do trabalho, é necessário dizer sobre o trabalhador, desse modo, esta pesquisa abordou tanto as especificidades do fazer desses profissionais, quanto a dinâmica de prazer e sofrimento vivenciada por eles. Observou-se que a percepção sobre a saúde mental relacionada ao trabalho dos usuários é atravessada pelo reconhecimento da centralidade do trabalho e do potencial criativo/destrutivo dos modos de trabalhar. Identificou-se a elaboração de estratégias defensivas e estratégias de resistência para lidar com as adversidades do trabalho. Para que seja possível colocar em circulação a Clínica do Trabalho para os usuários-trabalhadores, é primordial a constituição de uma Clínica do Trabalho Institucional voltada para os profissionais da saúde. Enfatiza-se assim, a importância dos espaços de fala e escuta, em que os profissionais do SUS possam compartilhar aquilo que faz sofrer no meio laboral, dando a esta carga psíquica um lugar de potência e transformação. A partir desse acolhimento poderão então estar disponíveis para um cuidado integral e humanizado, relativo a saúde dos trabalhadores-usuários, colocando em movimento um olhar permeado pela Clínica do Trabalho. / This thesis construction is based in the interrelationships between professionals and users of the Unified Health System (SUS), in relation to the mental health related issues related to work. Currently, there are proposals for policies and actions aimed at the workers' health, but the field of practices, in this context, has not produced meaningful answers to meet the demands of mental suffering from work. Thus, this research intends to understand how the health professionals perceive the work related mental health experienced by the SUS users. The theoretical and methodological basement is based on the Psychodynamics of Work and the theories focused on Health Mental and Work. The research method was based on Work Psychodynamics, in which the strictu sensu proposal was adapted, being composed by pre-research, research per se, and working through as validation. Women and men who work as health professionals in the SUS participated in the research. The analysis and interpretation material resulted from 15 individual and 4 collective interviews, totaling 69 participants. In addition, records made in the field diary also integrated the analyzed material, thus grounding the clinic observation. The results set out to meet the objectives of the research and originated five thematic axes, these being: Work and Subjectivity: Between knowledge and making; Mental Health and Work in SUS: Network Joints; Work Organization in the SUS Services; Health Productions and Illness at work; Research- Intervention as a Reflection-Transformation Possibility. When talking about work, it is necessary to tell about the worker, in this way, this research addressed both the specificities of the work of these professionals, and the dynamics of pleasure and suffering experienced by them. It was noted that the user’s perception about work related mental health is crossed by the recognition of the centrality of work and the creative/destructive potential of the ways of working. It was identified the elaboration of defensive and resistance strategies for dealing with adversity at work. In order to be able to put into circulation the work clinic for the user-workers, it is essential to establish an Institutional Work Clinic focused on the health professionals. This emphasizes the importance of spaces for speaking and listening, in which the SUS professionals can share what causes suffering in the workplace, giving this psychic burden a place of power and transformation. From this reception can then they be available for an integral and humanized care, concerning the health of the workers-users, putting in motion a look permeated by the work clinic.

Executive group coaching, as a development intervention, and interest in coaching research has steadily increased over the years. Psychodynamic group coaching and coaching programmes have, however, received limited empirical attention. In this study, the researcher argues the criticality for coaches in better understanding of unconscious group coaching dynamics. The researcher felt that by designing a Systems Psychodynamic Executive Group Coaching Programme (SPEGCP) as a psychoeducational developmentally focused learning opportunity would allow for an exploration of systemic conscious and unconscious group coaching dynamic behaviours. The researcher sought to explore, describe and analyse the lived experiences of coaches in the SPEGCP. Interpretative phenomenological hermeneutic, using systems psychodynamic perspective as a theoretical framework, served the study well by enabling the researcher to apply in-depth description and interpretation. A case study research strategy was adopted were individual participants were analysed and then integrated across participants analysis of findings. The study revealed the structured nature of the SPEGCP acted as a container, transitional object, and containment for coaches. SPEGCP contributed to the development of insights into the unconscious group coaching dynamics related to role, authority, boundary and identity manifested in uncertainties, role confusion, person-role-organisation dynamic influences and defensive structures in the paranoid-schizoid position, and reflective containment for learning in the depressive position. The quality of the relationship between the consultant-coach and group, and the systems psychodynamic consulting and coaching stance, were critical for exploration and reflective insights to emerge. As the systems psychodynamic group coaching and consulting stance can add significant value to the growth and functioning of coaches, and thus executives and their groups in which they operate, a study of this nature was important if not critical. The study provides an opportunity to consider that this third generation type of evidence based consulting and coaching be viewed as an integrated part of the development of coaches, consultants, and thus executive groups. / Psychology / D. Litt. et Phil. (Psychology)

[pt] Este estudo teve como objetivo analisar a psicodinâmica do trabalho de manicures em salões de beleza, além de identificar as vivências de prazer e sofrimento no trabalho e estratégias defensivas utilizadas por essas trabalhadoras para lidar o sofrimento. O estudo teve um delineamento qualitativo e contou com a participação de doze manicures que trabalham em salões de beleza. A coleta de dados foi realizada através de entrevistas do tipo semiestruturado com um único respondente. Os dados foram submetidos à técnica de Análise dos Núcleos de Sentido (ANS), proposta por Mendes (2007). Nas vivências de sofrimento de manicures em salões de beleza, destacaram-se a sobrecarga de trabalho; o custo físico causado pelos riscos ocupacionais da profissão; o ônus financeiro resultante da compra e da manutenção dos materiais de trabalho; e o desgaste emocional provocado por algumas clientes durante os atendimentos. As vivências de prazer no trabalho indicaram ser resultantes do reconhecimento do trabalho da manicure, por parte dos clientes; da identificação das manicures com as tarefas que executam; e da existência de relações de solidariedade e companheirismo no coletivo de manicures. Foram identificadas três estratégias defensivas individuais, autoaceleração, racionalização e compensação, e uma estratégia de defesa coletiva, relacionada a cooperação. Como consequências observou-se que a precarização do trabalho das manicures entrevistadas tende a potencializar os danos à saúde física e mental dessas trabalhadoras. / [en] This study aimed to analyze the psychodynamics of the work of manicurists in beauty salons, in addition to identifying the experiences of pleasure and suffering at work and defensive strategies used by these workers to mediate suffering. The study had a qualitative design and had the participation of twelve manicurists who work in beauty salons. Data collection was performed through semi-structured interviews with a single respondent. The data were submitted to the technique of Nucleus of Sense Analysis (ANS), proposed by Mendes (2007). In the experiences of the suffering of manicurists in beauty salons, work overload stood out; the physical cost caused by the occupational risks of the profession; the financial burden resulting from the purchase and maintenance of work materials; and the emotional exhaustion caused by some clients during the appointments. The experiences of pleasure at work indicated that they resulted from the recognition of the work of the manicure by the clients; the identification of manicurists with the tasks they perform; and the existence of relations of solidarity and companionship in the collective of manicurists. Three individual defensive strategies were identified, self-acceleration, rationalization and compensation, and a collective defense strategy related to cooperation. As consequences, it was observed that the precarious work of the interviewed manicurists can increase the damage to the physical and mental health of these workers

This study investigated the relationship between leadership style and group processes and dynamics with due consideration of the role of related systems in the context of organisational change. The theoretical assumptions and practical implications of the full range model of leadership were discussed. This model emphasises the transactional-transformational paradigm. In addition, approaches to studying and working with groups were covered, focusing specifically on group processes and group dynamics. In the case of the latter, the systems psychodynamic perspective was emphasised. The present study was conducted in a plant of a South African production organisation that had been experiencing transformation. An intervention was done at management level to identify behavioural and operational issues and to sensitise the members of the management team in terms of individual and group functioning. The conceptualisation of leadership styles in terms of the full range model of leadership was largely supported by means of associations with certain personality traits and behaviours. The latter also provided a profile of desired characteristics, especially in terms of interpersonal styles and work and social ethics. The theory on group processes and dynamics was used to explore group and organisational functioning. The context of change and the related insecurity resulted in efforts to deal with anxiety by means of excessive reliance on structure. Centralised leadership and a dynamic of control and dependency characterised all levels of the organisation. Cooperation in an interdependent manner was therefore problematic and there was also a struggle in terms of interrelatedness in and between systems. The unconscious defence strategy was related to the general reliance on transactional behaviours and the lack of authorisation of leadership in terms of transformational behaviours. Despite the successful application of theory in the present study and the contribution made by the results, it was concluded that the uniqueness and the realities of each situation need to be explored and provided for, and a system should be allowed to determine the progression in the system. / Psychology / D. Litt. et Phil. (Psychology)

This descriptive research addressed the challenges of working with the conscious and unconscious aspects of diversity in order to enhance insights into covert and deeper diversity dynamics in organisations. The research supported the evolving trend of shifting the systems psychodynamic orientation from the group to the individual context. The general aim was to describe a systems psychodynamic coaching model, and to determine its trustworthiness in assisting executives to work effectively with conscious and unconscious diversity dynamics. Literature was reviewed to provide a theoretical foundation of diversity challenges which executives face in South African organisations. This was augmented by systems psychodynamic literature, which provided a theoretical basis upon which to understand the intrapsychic aspects of the executives and their interplay with systemic dynamics. The empirical study was conducted over ten months to determine the trustworthiness of executive coaching in diversity from a systems psychodynamic perspective. Data was gathered using the organisational role analysis approach, and analysed by means of the systems psychodynamic discourse analysis method. Nine major themes and their related sub-themes were identified, namely, gender, race, ethnicity, authority, disability, language, age, de-authorisation of diversity work, and the coaching process. Through the coaching, the executives gained insights into their intrapsychic environment and the complex, multifaceted and intersecting nature of diversity in their organisations. They were assisted to take up their leadership roles more effectively and to take action on behalf of their organisations. The research hypothesis formulated and the conclusion made was that executive coaching from a systems psychodynamic perspective displays trustworthiness. / Industrial and Organisational Psychology / D. Litt. et Phil. (Consulting Psychology)

The historically black and historically white universities in South Africa were shaped by apartheid policies. Within this socio-political context the project started when I, who was a lecturer at a historically black university (HBU), was confronted by violent interactions between lecturers and students, and a perceived passivity on the part of management when lecturers were threatened by students with violence in social and academic settings. Based on socio-historical factors and my personal experiences, I explored the experiences of lecturers at an HBU, i.e. their relationship with students and management, to form an understanding about how the lecturers’ experiences influenced the unconscious dynamic processes of the intergroup transactions between themselves and the students and management. A qualitative research method was chosen because it allowed for the in-depth analysis and interpretation of the lecturers’ experiences in a particular HBU. Hermeneutic phenomenology, using the systems psychodynamic perspective, allowed for the description and interpretation of the lecturers’ experiences. Data collection entailed hermeneutic conversations with the nine lecturers from an HBU. In the analysis, interpretation and reporting of the findings, the interpretive stance proposed by Shapiro and Carr (1991) was used. This analysis and interpretation entailed a collaborative dimension – the analysed data was sent to the lecturers to ascertain whether the analysis was a reflection of their experiences, as well as to experts in the systems psychodynamic perspective to ascertain whether the interpretations were plausible. The relationship between students, lecturers and management was contradictory, because it was marked by hope for an effective working relationship and by continuing conflict and violence – resulting in the (k)not of relationship based on the (k)not of achievement apparent in the lecturers’ relationship with students, and the (k)not of performance evident in their relationship with management. The intergroup transactions between students, lecturers and management were marked by a reign of terror as threats of violence, or actual physical violence, were directed at lecturers by students with little or no intervention by management. By integrating the findings with systems psychodynamic literature, several working hypotheses and two research hypotheses regarding the (k)not of relationship between the three stakeholders were generated. / Psychology / D.Litt. et Phil. (Psychology)

INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations

Made available in DSpace on 2016-04-28T20:39:26Z (GMT). No. of bitstreams: 1 Luciana E S Mennucci.pdf: 443670 bytes, checksum: 014c895f99e43904481117d01b5f4ff0 (MD5) Previous issue date: 2007-05-18 / In this dissertation I proceeded from the certification of the difficulty imposed by the standard psychoanalytic practice in the treatment of patients with feeding problems, to obtain positive results in the patient s relationship with his or her feeding, which would oblige me to introduce changes to the technique to the treatment of these patients. I sought, therefore, to study the field of feeding and the consequent feeding problems, which permitted me to enter some of the rules constituting this field such as: the social conditions of the production of symptoms, the diet mentality, the psychomechanics and the psychodynamics of feeding. Another route followed was of a search for legitimization in the changes of technique by penetrating the difference between techniques and psychoanalytic method. Maintaining in the background the studies of Susan Orbach, I took as a hypothesis that the diet mentality is a cause for great part of feeding problems and not their cure. I had to sustain myself in systematic readings about psychoanalysis, gastronomy and anthropology of feeding, as well as proceeding to the systematic study of the Multiple Fields Theory in the thematic of the psychoanalysis of the quotidian. Thus, in the course of this dissertation it became increasingly clearer that, as some of the rules of the field were revealed, specifically of the diet mentality, the route that favors an autonomy of feeding possible to the patient could be reached by the utilization of an active technique capable of touching the pure act regime that conforms the diet mentality. In this way, I could also organize the results of the reflection about my clinical work and in the conclusion that the diet mentality is both cause and consequence of a great part of feeding problems. It alienates the man of the contemporary world from the vital signs of feeding. To this man, the act of feeding, regulated by the pure act regime, ceases to be a personal decision, becomes imposed from the outside and turns into the meaning that would previously be attributed by thought / Nesta dissertação, parti da constatação da dificuldade enfrentada pela clínica psicanalítica padrão no atendimento a pacientes com problemas alimentares. Em minha clínica, para obter resultados positivos na relação do paciente com sua alimentação, via-me freqüentemente obrigada a introduzir mudanças de técnica no atendimento desses pacientes. Procurei, então, estudar o campo da alimentação e os conseqüentes problemas alimentares, o que me permitiu adentrar algumas de suas regras constitutivas, como: as condições sociais da produção dos sintomas, a mentalidade de dieta, a psicomecânica e a psicodinâmica alimentar. Outro caminho seguido foi o da busca de legitimação nas mudanças de técnica pela problematização da diferença entre técnicas e método da psicanálise. Tendo por pano de fundo os estudos de Susan Orbach, pude tomar como hipótese ser a mentalidade de dieta a causa de grande parte dos problemas alimentares, e não sua cura. Precisei amparar-me em leituras constantes sobre psicanálise, gastronomia e antropologia da alimentação, além de proceder ao estudo sistemático da Teoria dos Campos no tema da psicanálise do quotidiano. Assim, no discorrer da dissertação, foi-se tornando mais claro que, ao se revelarem algumas regras do campo da alimentaça&#61485;o especificamente da mentalidade de dieta, abre-se o caminho favorecedor da possibilidade de uma autonomia alimentar para o paciente, a qual pôde ser alcançada pela utilização de uma técnica ativa capaz de tocar o regime do ato puro que conforma a mentalidade de dieta. Dessa forma, pude também organizar os resultados da reflexão sobre meu trabalho clínico na conclusão de que a mentalidade de dieta é causa e conseqüência de grande parte dos problemas alimentares. Ela aliena o homem contemporâneo dos sinais vitais da alimentação. Para esse homem, o ato de alimentar-se, regulado pelo regime do ato puro, deixa de ser uma decisão pessoal, impõe-se de fora e passa a ser o sentido que lhe seria previamente atribuído pelo pensamento

Os trabalhadores da Fundação de Atendimento Socioeducativo do Rio Grande do Sul têm sido identificados como um grupo em grande vulnerabilidade psicossocial para a ocorrência de sofrimento mental decorrente do trabalho. Este estudo teve como objetivo principal compreender a influência do trabalho na saúde mental desses servidores, através da análise das relações laborais lá existentes e de que forma a organização do trabalho está imbricada nesse processo. Os objetivos específicos foram conhecer as percepções dos servidores sobre seu ambiente de trabalho, identificar os efeitos da organização do trabalho no cotidiano dos servidores e identificar as motivações que fazem que os trabalhadores permaneçam na instituição. Foi realizada uma pesquisa qualitativa, tendo como embasamento teórico a Psicodinâmica do Trabalho de Dejours, utilizando diários de campo e 14 entrevistas realizadas com 13 sujeitos lotados na Comunidade Socioeducativa, no Centro de Atendimento Socioeducativo Regional de Porto Alegre e na Sede Administrativa Padre Cacique, em Porto Alegre. Para os resultados utilizou-se análise de conteúdo de Bardin (2011) e o Software NVIVO. Os principais resultados observados foi lacuna importante no que se refere à saúde do trabalhador na instituição. As situações de sofrimento gerado pelo excesso de horas extras estão configuradas como um dos pontos nevrálgicos do sistema. O déficit de funcionários, a falta de controle nos processos de trabalho e a dependência salarial das horas extras faz com que um número significativo de trabalhadores abdique de sua qualidade de vida em prol de adquirir bens e prover as famílias com maior conforto. Esses pontos, entre outros, acabam desencadeando um elevado número de afastamentos por questões de saúde mental e sofrimento psíquico no trabalho. A possibilidade de criação de projetos e participação nas decisões figuram como importantes auxílios para a manutenção da saúde mental nesse ambiente. Por conseguinte, a permanência na instituição pode ser explicada por diferentes razões como a identificação com a socioeducação, com trabalhos sociais ou comunitários, a remuneração acima do mercado, a possibilidade de crescimento financeiro, as estratégias de defesas e a acomodação profissional. É urgente, portanto, a necessidade de intervenção e melhorias na organização do trabalho nessa população. Assim, uma parceria com o Serviço Especializado em Engenharia de Segurança e em Medicina do Trabalho da instituição já foi iniciada e este trabalho têm servido de dados para que este processo seja o mais sumário possível. / People who work at the Foundation for Social and Educational Service of Rio Grande do Sul have been considered as a highly vulnerable group to the occurrence of mental suffering because of labor. This study aimed to understand the influence of work on those workers’ mental health, through the analysis of labor relations, and how the labor organization is interconnected to this process. The study’s specific objectives are to get to know the perceptions of the servants on their workplace, to identify the effects of the labor organization in the routine of servants and to identify the reasons for the workers to remain in the institution. A qualitative research, was made as a theoretically based on the Dejours’s Psychodynamics of Work, using field diaries and 14 interviews with 13 people who work in the Social and Educational Community, in the Regional Social and Educational Service Center of Porto Alegre, and in the Administrative Office Padre Cacique, in Porto Alegre. For the results we used using Bardin’s content analysis (2011) and the software NVIVO. The main results observed were an important gap considering the workers’ health in the institution. The suffering situations caused by the excessive overtime work are considered one of the system’s essential issues. Workers shortage, lack of control in the labor processes and wage dependency of overtime working lead to a significant number of workers who give up their quality of life in order to acquire goods and provide more comfort to their families. These aspects, among others, end up triggering a large number of absences due to mental health issues and mental suffering at work. The possibility of creating projects and the participation in decisions seem to be an important aid for the maintenance of mental health in this environment. Consequently, different reasons may be used to explain the decision to stay in the institution, such as identification with social education, social or community work, the salary, higher than market average, the possibility of financial growth, the defensive strategies and the professional adaptation. It is urgent the need for intervention and improvements in this population’s labor organization. For this reason, a partnership with the Specialized Service of the institution’s Safety Engineering and Occupational Medicine has already been created and this study has been giving access to data for this process to be as direct and simple as possible.

INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations